Individual Information

ANNETTE SHREE MIDDLEBROOKS

AUSTIN, TX 78717-6078

Active

licensing@ehealthinsurance.com

09/05/2021

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3718059	09/05/2021	Active	09/05/2021	09/30/2024

Qualification Type	Original Issue Date	Status	Effective Date
Health	09/05/2021	Active	09/05/2021
Life	09/05/2021	Active	09/05/2021

Company Name	Appointment Type	Status	Active Date
17687
MOLINA HEALTHCARE OF NEVADA INC	Health	Active	09/29/2023

row(s) 1 - 1 of 1

Organization	Association Type	Type	Beg dte	End dte
SUTHERLAND GLOBAL SERVICES INC	Designated Resp Lic Prdcr	Agency	01/12/2022	-

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